Cardiovascular Disease Assessment Prior to Kidney Transplantation
Cardiovascular disease is highly prevalent and the leading cause of mortality in patients with chronic kidney disease, end-stage kidney disease, and kidney transplantation. However, kidney transplantation offers improved survival and quality of life, with an overall reduction in cardiovascular disea...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Houston Methodist DeBakey Heart & Vascular Center
2022-09-01
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| Series: | Methodist DeBakey Cardiovascular Journal |
| Subjects: | |
| Online Access: | https://account.journal.houstonmethodist.org/index.php/up-j-mdbcj/article/view/1117 |
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| Summary: | Cardiovascular disease is highly prevalent and the leading cause of mortality in patients with chronic kidney disease, end-stage kidney disease, and kidney transplantation. However, kidney transplantation offers improved survival and quality of life, with an overall reduction in cardiovascular disease events; therefore, it remains the optimal treatment choice for those with advanced kidney disease. Pretransplantation cardiovascular assessment is performed prior to wait-listing and at routine intervals with the principal goal of screening for asymptomatic cardiac disease, intervening when necessary to improve long-term patient and allograft survival. Current clinical practice guidelines are based on expert opinion, with a lack of high-quality evidence to guide standardized screening practices. Recent studies support de-escalation in screening with avoidance of preemptive revascularization in asymptomatic patients, but they fail to provide clear guidance on how best to assess the cardiovascular fitness of this high-risk group. Herein we summarize current practice guidelines, discuss key study findings, highlight the role of optimal medical therapy, and evaluate future directions for cardiovascular disease assessment in this population. |
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| ISSN: | 1947-6108 |